Veteran neurosurgeon, Dr James Goodrich led team that performed 20-hour op which they almost stopped half-way through, because the boys shared a lot more brain tissue than expected

Conjoined 13-month-olds Jadon and Anias McDonald were successfully separated Friday morning after more than 16 hours of surgery at the Children’s Hospital at Montefiore Medical Center in The Bronx, New York.
Anias and Jadon are recovering after their life-threatening operation on Thursday. This procedure is so rare that it was only the 59th craniopagus separation surgery in the world, since 1952.
According to their surgeon, Dr James Goodrich, it is incredible they made it this far.
The twin boys w born via cesarean section last September near Chicago, Illinois.
were attached by the crown of the head. Their parents Nicole, 31, and Christian McDonald, 37, believe they are perfect
Based on national statistics for craniopagus twins, Anias and Jadon have defied significant odds to come this far and made it to 13 months. Around 40 per cent are stillborn, with a third of survivors succumbing within 24 hours of birth. If they survive beyond that point, there is still an 80 per cent risk, craniopagus twins would die before the age of two if they are not separated.

Nicole and Christian McDonald made the brave decision to go for the risky surgical procedure to give their boys a shot at normal life

Brave parents, Nicole and Christian, made the tough decision to go for the surgery despite the possibility of death or long-term brain damage for one or both of their twin sons.
Dr. James Goodrich, a neurosurgeon who specializes in the separation of twins conjoined at the cranium, led the operation. Their parents Nicole and Christian, sat in the waiting room the whole time.
At 3 a.m., he informed the McDonald family of the actual separation “Well, we did it,” said Goodrich, a veteran of six previous separation surgeries.
However by 6 a.m., the boys were still undergoing surgery to reconstruct their skulls.
Jadon was the first of the boys to be finished. He was wheeled out of the operating room around 7:40 a.m. on a stretcher, and taken to the pediatric intensive care unit where he was reunited with his teary, overcome parents, Nicole and Christian.
As of 8 a.m., Anias was still undergoing surgery.
Half way through the operation, the veteran neurosurgeon and his team contemplated stopping the procedure altogether when they discovered the boys shared far more brain tissue than they had expected – despite using 3-D imaging for the pre-op preparations.

Anias and Jadon went through marathon surgery , beginning early Thursday morning to late Friday morning to separate the brain tissue that conjoined them at birth

Jadon (pictured), is recovering in his ward on Friday. His twin, Anias was still in surgery late on Friday morning since he was more affected by the separation of their brain tissue

Anias (pictured), now out of surgery also recovering in his ward on Friday.

Hardest hit by the surgery is Anais. reports have it that with every cut, his heart rate and blood pressure plummeted. Eventually the team found an opening and successfully separating the boys.

As of late Friday morning, while Jaden is recovering relatively well, Anias was still in surgery. There is the possibility he could face severe physical issues, later.
Relieved mom, Nicole, Friday was on Facebook with an explanation and details for the thousands of people that have followed the family’s journey.
‘The overall atmosphere was one of celebration mixed with uncertainty,’ she explained.
‘Anias really got rocked in this procedure. It really now is up to God in terms of how he recovers.’
She said: ‘I keep picturing Anias smiling behind his right middle finger in his mouth. Twenty four hours ago he was so rambunctious…full of life. God please give me my baby back.’

Mom Nicole with Anias and Jadon. In the last few months doctors had placed tissue expanders in the boys’ head to make it easier to separate them, creating enough skin to stitch each head back up

But it wasn’t all contemplative as she reports on Jadon: ‘Jadon is such a rock star. They said he hardly batted an eye through the whole procedure in terms of maintaining his vitals.
‘It’s a bit surreal to sit here and type this…I should feel so happy…TWO SEPARATE BABIES!!!…and yet I ache with the uncertainty of the future.
Describing a celebratory atmosphere mixed with uncertainty Nicole wrote
‘I didn’t cry until the surgeon’s left the room. I was barely able to even utter the words “thank you” because of the pit that still sits heavy in my stomach. We are standing on the brink of a vast unknown.’
They boys were born via cesarean section last SeptemberThey boys were born via cesarean section last September near Chicago, Illinois.
They were attached by the crown of the head. Nicole and Christian who also have a 3-year-old son Aza, insisted the boys were perfect as they were.
To give their twin boys a chance to lead a normal life, they have traveled to Montefiore Hospital in the Bronx, New York, for a rare and expensive surgery performed by one of the world’s most esteemed surgeons, who will separate their heads – cost, $2.5 million.

Parents, Nicole and Christian McDonald (in white) with the surgeons as the prep the boys for the theater on Thursday in Montefiore Hospital, NY

The operation started at 7.15am on Thursday morning.
‘I could almost keep them like this,’ Nicole told CNN before the operation, admitting that she had become attached to the boys this way.
She said she knew this was for the best, but the fear that something could go wrong during surgery was excruciating.
‘This is so hard. I’m not going to sugarcoat it,’ she said.
Anias and Jadon, who have a three-year-old brother Aza, are technically called ‘craniopagus twins’ – a phenomenon that occurs just once in every 2.5 million births.
Based on national statistics, it is astonishing they made it to 13 months.
Around 40 per cent of craniopagus twins are stillborn.
Of those that survive, a third die within 24 hours of birth.

Proud parents, Nicole and Christian McDonald

Nicole and Christian gave up their jobs and life in their town near Chicago, Illinois. They moved to the Bronx with older son Aza, seen here playing with his brothers, to give their twins a fighting chance.

The operation was performed by Dr James Goodrich, a neurosurgeon who specializes in separating conjoined twins at the head has it’s own pitfalls for the conjoined twins. In this case, one or both of the boys may suffer developmental complications.

‘We know that is definitely a real possibility, but we’re still going to love our boys,’ Christian said before the surgery.
For instance, it is now clear Anias will likely suffer more severe disabilities than his twin brother.
The team has spent months practicing and planning their strategy using a physical 3D model of the boys’ heads, plus computerized 3D modeling, where they can look at different scenarios. The difficult process will be separating the tangled veins the boys share, not dissimilar to that in this diagram
Dr Oren Tepper, a plastic surgeon, was in the room to reconstruct the skulls and stitch each head closed. Doctors have spent the last few months placing tissue expanders in the boys’ head to make it easier to separate them, leaving enough skin to stitch each head back up.

Dr James Goodrich (seated) led the team in the surgery to separate the twins. It was successful. Now they will spend 72 hours in intensive care, then months in a rehab center

Dr James Goodrich (in green), separated the twins conjoined at the head

‘This is about as complicated as it gets,’ Dr Goodrich told CNN ‘I know the vascular system we have to go through is complex.

‘It’s big. It’s doable, but it’s going to be tedious.’
But even despite the state-of-the-art technology, they were not prepared for the 5x7cm brain tissue the boys shared, that they had to separate.
They will now spend 72 hours in intensive care, then months in a rehab center.
According to Dr Goodrich, their speech skills will not be affected, given that he is dealing with the back of the brain, but there is a chance they will struggle with movement.
He told CNN: ‘They have no back control because they’ve never sat up. They’ve never crawled.’
The family has health insurance, which covers a significant amount of the $2.5 million surgery., leaving a shortfall of $100,000, to donate, visit their GoFundMe page.